Tuesday, August 27, 2013

One of the most important skills in language intervention is the development of personal narrative skills. These are the basis for all conversational interactions and social connectedness. We talk about what we’ve done or what we’re going to do. We talk about the fun things we’ve done or the bad days at work. (Or even the great days at work.)I spend a lot of time working on developing these personal narratives with kids; particularly kids who can’t talk. How can we get them to tell us about their experiences, their feelings, their desires (beyond requesting an item)?There have been some great studies by Gloria Soto and her colleagues and students at SFSU. One of the first apps out for creating personal stories/books was Pictello. Pictello

allows you to import your photos, input text, has text-to-speech to record your voice options, lets you decide how many pages, lets you add labels to your photos, and even has a step-by-step tutorial built into the app.Book Creator

also offers a tutorial when you open the app. You can add and resize images, add your text, and create more pages. When you’re done, you can import the book into iBooks to read it, or Dropbox to share it.In my experience, Story Creator needs the user to be intuitive. There seems to be less flexibility in this app. Each book is like a photo album to which you can add text and sound. There are crayons with which you can draw your own pictures or embellish your photos.The Story Dice app is just like the actual dice set for stories. You choose how many die to roll, and are given simple icons to represent the story elements you need to use. There are some instructions for how to play to construct stories and sentences singly or in groups.Storybook Maker

appeals to a younger crowd, with stickers and a note to send the book to grandma and grandpa. There are a variety of page layout options (about 12), and lots of options for backgrounds and borders, objects to add that have some animation.You don’t need a specific story app to retell stories. Check out ToonTastic! Puppet Pals, and Felt Board to create scenes and pages. There is a great post with video for using Puppet Pals to retell stories here.http://mindwingconcepts.com/Language-Development-Literacy-RTI-blog/put_the_story_on_stage_with_puppet_palsSean Sweeney, who made that video also made this one on using Tellagami for the same purpose. See it here. http://www.speechtechie.comThere are many other book maker options for creating personal stories, some of them very inexpensive. For SLPs this is great news. We can work on constructing narratives about what the child did, when he did it, where he did it, who he did it with, whether he liked it or not, what happened that was memorable, and more. And then he can tell them again and again, gaining the very important experience of retelling stories (as Carol Westby reminds us) that nonverbal children - and those with language disorders - just don’t always get. Another way to use many of these apps for story re-telling is to use the camera in your iPad to take pictures of the characters, settings, and events in the child’s favorite books. Import those pictures into the story making app and re-create the story in a simpler form consistent with the language level of the child (or just a bit higher). Now he can retell the story to you, to his teacher, to ....everyone. This story retelling is something that typical children do all the time. They “read” books to the dolls and stuffed animals, and even their parents. But our children with language disorders don’t get this kind of experience, which is vital to their development of conversational, social, and academic skills.And now, Mindwings, the company owned by the creator of the Story Grammar Marker has an app that goes with her other materials for telling stories and personal narratives. She has some great handouts available. Get one here for free.http://www.slideshare.net/mindwingconcepts/mindwing-autismhttp://www.slideshare.net/mindwingconcepts/mindwing-autism

Monday, August 19, 2013

There are so so many apps out. And we all want to use them. But how to find the “good” ones? There are so many to wade through and you can’t possibly look through them all. So, I am going to post a few suggestions here about apps I like to use.

My absolute favorite - and this is true for many SLPs I’ve spoken with - are the Toca Boca apps. They are just a lot of fun and can promote interactions in a genuine way. Because genuine communication is what we’re after, right? The first Toca Boca app I ever used was Toca Tea Party. A flood of memories of all my daughter’s tea parties when she was little, and excursions to fancy hotels for “high tea.” I love using this app when I do evaluations. (1 iPad for interaction, 1 for fun apps - what a lot of technology!) We can talk about which plates or cups or treats we want. We can comment about being hungry or thirsty or how good something tastes. We can ask for more and say we’re finished. Depending on your student/client there are some fun conversations to be scaffolded.Of course, I see more boys than girls. So, I have “had” to acquire Toca Builders, Toca Kitchen Monsters, Toca Robot Lab

(my favorite), and many more. Again, just talking through the actions and sequences provides opportunity to input language and scaffold responses. These are really fun and engaging apps that the kids (and some older clients) really like. They stay focused and whatever they do within the app is an opportunity to generate a language response.

Another favorite is Bamba Burger. Recently I spent almost half an hour with a young man with autism building burgers and cutting french fries. I had lots of opportunity to make comments about his choices for toppings (fish? octopus?), and I got him to talk about what he wanted and whether he liked it or not. He also liked their Ice Cream Parlor app.

Other apps for building language: Educreation allows you to make lessons your students can watch over and over again. Quizard lets you make your own flashcards, Talk about it objects asks students to “tell me everything you can about a cat.” See Touch Learn also allows you to create custom flashcard sets.

But, to be honest, I’m not into flashcards any more. Even Lovaas acknowledged you can’t teach language in discrete trial drills. Work in context. Create those contexts. That is what makes the Toca Boca apps work so well for working on language. Many of the contexts are familiar to kids, and the others are play routines that give our kids room to grow. One thing I am constantly telling SLPs and teachers is this: “Therapy with kids with AAC systems or with other technology is not any different from the therapy you have always been doing. It’s just a different mode of expression, or different “virtual” toys to play with.”Have fun !

Friday, August 16, 2013

One problem that school based SLPs have when it comes to aac assessment is a lack of equipment. A good aac assessment tries a variety of options with a student, with different symbol sets, symbol sizes, array complexities, and other software features. Organization of vocabulary is one of the biggest features to consider, overriding almost everything else. There are few assessment centers that offer a full range of assistive equipment to try. But there are also few districts that can provide SLPs with such a range. So, how do we make good choices based on effective assessment?Recently we have been hit with an iDevice explosion. Many districts are even by-passing assessments and offering kids and their parents an iPad with aac app as soon as the words, “AAC evaluation,” pass their (or their advocate’s) lips. Many SLPs fear this is subverting the process and may not provide the students with the system that really meets their needs.The iPad revolution has, however, provided us with a tool that we can use effectively - and relatively cheaply - to help us in the assessment process. There are many many aac apps available in the iTunes store. However, way too many of them represent nothing more than 1 more choice board, in my opinion. There are few robust aac apps that offer well organized vocabulary sets, a full range of symbols to use, flexibility in array size and complexity, and layers of navigation that are systematically well organized. Among them, I believe, are Prooquo2Go(particularly in its version 2 and beyond updates), Sono Flex, LAMP Words for Life, and Touch Chat (various versions). Each has its pros and cons, and I won’t make a plug for any of them here. Sono Flex is the least expensive of them, at about $100.For a little less, I have purchased Go Talk Now(about $80.) and taken advantage of its many features to create a large range of assessment activities. I use these in conjunction with activities from other apps and, of course, paper-based systems that range from a small-choice array through the various display options of the PODDand Pixon books and boards. (more on these later). I can create pages with 1, 4, 9, 26, or 25 buttons per page, link them in any navigation pattern I wish, use symbols from the app’s library (which includes some realistic photo-like symbols as well as standard symbol libraries), combine more than 1 symbol on a button, resize the images and text, import photos, videos, and audio tracks, and more. I have created a master home page that links me to different options of linked page sets. Now, within an assessment session, I can move almost seamlessly from a 4 core word display to 25. I can change button and background colors and add audio information for kids with cortical vision impairments. I can choose between recorded voice and synthesized speech - in multiple languages. I have made multiple activity based pages with core words in stable locations for activities that are preferred by many of the kids I see, in sizes from 4 to 25 buttons per page, and can see how far I “push the envelop” within the scope of a session.I hope that’s give you something to think about - and a project to keep you busy.

For a more complete explanation with screen shots and app descriptions, I have my presentation Lightening the AAC Tool Kit Load (originally presented at Closing the Gap 2012) in my TPT store here.

Thursday, August 1, 2013

Hi. And welcome back as I continue to talk about AAC this month. This is a huge topic, of course, and I’ll be coming back to it periodically throughout the year. This month I’m just trying to talk about some of the basics. So, today’s topic is vocabulary organization.

This is a topic that has been debated throughout the relatively short history of aac. It may be the most hotly debated topic in ASHA, and has been the source of multiple guidelines and proposals. I do think, however, that we may be closer some concensus.

So, here’s the basic debate. Proponents of the use of core vocabulary in aac posit that much time is spent -wasted - providing unending lists of content based vocabulary (Baker, Hill, Devylder; 2000). They prefer to use core words and broad meanings; particularly words with multiple meanings and high frequency of use. And they focus on use of words only - no static phrases - to enable the user to combine words to construct genuine messages. Static phrases do pop up in social chat pages and other high frequency places to enhance the speed of communicating in some contexts. Core words are re-usable words. Use of core words minimizes the “real estate” needed on a display page, and gives the student access to the most often used words to create their messages.

On the other hand, others ask, “Why limit vocabulary access?” Does access only to core vocabulary limit students’ messages? Should we focus instead on pragmatic intent and how to use language instead of word selection? Shouldn’t we teach children to use a variety of functions and show them how to find the vocabulary they need for each of those, while providing them with a rich and varied vocabulary to use in all contexts?

Gayle Porter’s Pragmatic Organized Dynamic Display books use pragmatic branch starters to define message intent first and foremost, then teach how to find the words needed for the message based on the intent. These books provide a rich and varied vocabulary to meet all needs and provides a built-in system of navigation conventions for dynamic display.

And then there are those who continue to use topic or category-based communication boards/pages, moving students to core vocabulary as their fringe vocabulary grows. As speech-language pathologists many of us think of words in terms of categories and functions. Many communication systems have been built, historically, around basic categorization - words for things to eat, for things to play with, etc. Unfortunately, few - if any - of these systems have provided a way to vary function and increase narrative or syntax. These systems provide groups of words that are predominantly nouns. There may be a page of verbs, or a couple of specific verbs for each noun group. Some adjectives are provided usually - particularly colors, shapes, and feelings. There is limited ability to construct genuine messages, build syntax skills, or move beyond requesting and some limited responding.

Just a brief note here about core vocabulary for those uninitiated. Core vocabulary is that smallish set of words we use for most of what we say. The average toddler uses only 25 words for more than 95% of what they say (Benajee et all 2003 ). The average adult uses only 300-500 words for about 80% of what we say (outside of professional vocabulary). Core words are identified through word frequency, reflecting the most commonly used words in a language. These are composed of pronouns, prepositions, determiners, conjunctions, and verbs - but not nouns for the most part. They are words that provide substance to a message and, in aac, are words that help provide information when a specific words is not available.

So, back to the debate. You may be a proponent of one school or the other consistently throughout your practice. Or, you may make a thoughtful decision each time you put together an aac system for a student, considering the individual needs and circumstances. But what you always need to do is to organize the words the student is going to have and teach her how those words are related. We may teach “go” and “ride” in the contexts of their use, and ow to use them in multiple contexts for different meanings, but we still need to teach that these words are about doing something, and that the doing something words are in (X) location in the system.

On a core word display the word “go” is among the first words taught, and available on the front page. “Go” is taught in many contexts: get in the wheelchair and go someplace, go on the potty, get in the car and go somewhere, make it go by turning it on, go start an activity, go away and leave me alone. In all cases, the focus is on that one word on the first page in that one location.

In a pragmatic display, the focus is on the type of message. Yes, “Go” is right there on the pragmatic branches page. But it leads to the places page to tell where you want to go, or where you went, or where you are going to go, or where you are going. Using this “go” button takes us to options of where that somewhere is that you go. To ‘go start an activity’ you would start with the ‘I want to do some activity’ message button, and then from there explain what wants to ‘go.’ You’d find “go away” on the first page of “quick words” because it is used a lot and needs quick access. In this sytsem, to say “Let’s go” you request to go. To ask “Are we going” you’d start with a question intent. To tell about going, you’d go to the telling about or telling a story button(s). To ask to go play, you’d start with the activity button. The emphasis here is on the intent of the message. We teach the students how to indicate the type of message they want to deliver, as well as a consistent navigation system to control the content of the message.

Below are the 30-location Pixon board from Gail VanTatenhove and the 20 location PODD one page opening pragmatic branches page from Gayle Porter.

So, who am I?

As a speech-language pathologist for almost 40 years, I am passionate about giving other SLPs, parents, special education teachers the tools they need to implement AAC with fidelity and evidence based practices. I have worked with kids and adults with a wide range of disabilities; especially kids with autism. I have also worked in the public schools with kids with significant language learning disabilities. I give workshops, provide training to school district staff, speak at national conferences, and provide evaluations for speech-language and AAC.

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